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Wound Care Flashcards

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1
Q

Characteristics of the epidermis

A

outer epithelial layer
protective barrier
avascular
prevents dehydration of underlying tissue

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2
Q

Characteristics of the dermis

A

highly vascular

strong and elastic due to collagen and elastin

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3
Q

What does the dermis contain

A

hair follicles
sebaceous glands
nerve endings
receptors for pain, touch, cold, heat

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4
Q

Characteristics of the subcutaneous layer

A

below dermis
adipose tissue
connective tissue-fascia

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5
Q

What does thhe subcutaneous tissue do

A

provide insulation, support, cushioning

protects underlying tissue

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6
Q

what is a partial thickness wound

A

through the epidermis into dermis

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7
Q

What are the phases of normal wound healing

A

inflammatory
proliferative
maturation/remodeling

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8
Q

what does the inflammatory pahse do

A

prepares wound for healing and cleans debris

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9
Q

What does the proliferative phase do

A

rebuilds the damaged structures and provides strength to the wound

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10
Q

what does the maturation/proliferative stage do

A

modifies the immature scar to a mature scar

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11
Q

What occurs during the inflammation phase

A

control bleeding and combat infection

signal cells necessary for repair and regeneration

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12
Q

How long does inflammation last

A

acute: 24-48 hours
subacute: up to 6 days

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13
Q

Cardinal signals of the inflammatory phase

A 
swelling 
redness
warmth
pain
decreased function
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14
Q

What are the 4 events that occur in the proliferative phase

A

angiogenesis
granulation tissue formation
wound contraction
epithelialization

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15
Q

what is angiogenesis

A

formation of new blood vessels

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16
Q

what is granulation tissue formation

A

temporary connective tissue that goes across and fills the wound

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17
Q

What is wound contraction

A

edges of wound grow closer together

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18
Q

what is epithelialization

A

epithelial cells that go across temporary granulation

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19
Q

what is the purpose of the proliferative phase

A

resurfacing of the wound bed

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20
Q

What does the tissue look like in the proliferative phase

A

red, beefy, fragile

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21
Q

how long does the proliferative phase last

A

2-24 days

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22
Q

How long is the maturation/remodeling phase

A

21 days on

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23
Q

what happens in the maturation/remodeling phase

A

changes in the bulk, form, and strength of scar

granulation tissue must be strengthened and reorganized to fit surrounding tissue

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24
Q

When does the greatest change occur in the maturation/remodeling phase

A

6-12 mo

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25
What are the 3 methods of wound closure
primary secondary delayed primary
26
What is primary wound closure
``` edges touch (what you think of with surgical wound) can use staple glue stitches ```
27
What is secondary wound closure
wound edges dont touch
28
what is delayed primary wound closure
wound edges can be touching but wait to close
29
What is eschar
dry darker black dead tissue
30
What is skin
largest organ in the body | interphase b/t body and env.
31
What is slough
moist, green-yellow, slimy dead tissue
32
what is desiccation
look dry, including edges
33
what is maceration
too moist/wet | makes tissue fragile
34
What is undermining
use q tip to go underneath edges of wound b/c it extends past edges
35
What is tunneling
stick something under skin b/t 2 wounds
36
What is exudate
Thicker liquid b/c more protein in it | yellow, cream
37
what is transudate
generally blister | clear watery fluid
38
what is periwound
edge of wound | where edge of wound stops and healthy skin begins
39
Factors affecting wound healing
wound characteristics local factors systemic factors
40
Wound characteristics affecting healing
``` mechanism of onset time since onset location dimensions wound hydration necrotic tissue or foreign bodies infection ```
41
local factors affecting wound healing
circulation (diabetes, cold, fear, pain, peripheral vascular diseases) sensation (perihperal neuropathy, stroke) mechanical stress (pressure ulcer)
42
systemic factors affecting wound healing
``` Age inadequate nutrition comorbidities meds behavioral risk taking ```
43
Types of wounds
``` Arterial insufficiency Veous insufficiency pressure ulcers neuropathic ulcers burns trauma ```
44
What is the pain like in arterial wound insufficiency
severe | increased with elevation (b/c decrease circulation more)
45
What is the location of arterial insufficiency
Mostly LE (distal toes, dorsum of foot, lat malleous, ant, leg, areas of trauma)
46
What is an arterial insufficiency wound like
``` Base pale poor granulation round regular margins little to no bleeding,drainage necrotic tissue ```
47
What is the appearance of an arterial insufficiency wound
Thin, shiny, ddry skin, hair loss, cool skin
48
What are pulses like in arterial insufficiency wounds
decreased or absent pedal pulse
49
Factors leading to arterial insuffiency ulcers
``` Smoking diabetes hypertension advanced age trauma hypolymphedma ```
50
what is the pain like in venous insufficiency wounds
mild to moderate | decreased w/ elevation/compression
51
What is the location or venous insifficiency wounds
Medila lower leg, medial malleous, areas of trauma
52
what is the wound like in venous insufficiency
Red wound bed good granulation irregular margins copious drainage
53
What is the appearance of a venous insufficiency
edema | normal to warm skin temp
54
What is the pulse like in venous insufficiency
normal
55
Where are the most common places for pressure ulcers
bony prominences (sacrum, greater trochanter, heels)
56
Where are common locations for neuropathic ulcers
heel, ball of foot, big toe
57
What are burns classified by
Type and depth
58
What are the goals of wound care
``` protection reduce strain on nearby tissue protect periwound reduce pathogenic microorganisms in and around wound speed up healing process reduce/decrease scar tissue ```
59
What to document and assess in wound care
``` Location size undermining/tunneling wound bed edges drainage odor surrounding skin wound healing ```
60
What are the two methods of debridement
selective | nonselective
61
What are form of selective debridement
sharps autolytic enzymatic biologic
62
what is autolytic
use bodys own enzymes to get rid of tissue
63
What is enzymatic
put topical enzyme on wound
64
What is biologic debridement
use maggots
65
What are nonselective forms of debridement
mechanical-scrubbing, whirlpool | Surgical
66
Universal precautions for wound care
use gloves use appropriate disposal containers use a sterile field when debriding a wound
67
Modalities for wound care
``` Whirlpool e stim ultrasound hyperbaric o2 pulsatile lavage vac compression ```
68
What type of env do wounds heal faster
moist

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